When Your Family Is Struggling: A Complete Guide to Family Therapy

By The Counseling Place Team | Lone Tree & Greenwood Village, CO

Families are complex systems. Each member brings their own personality, history, needs, and ways of making sense of the world. Under normal circumstances, families develop rhythms, patterns, and norms that allow them to function — to communicate well enough, to manage conflict well enough, to provide each other with enough of what they need.

But every family also encounters periods when those rhythms break down. A teenager who seems to have become a different person overnight. Parents who are no longer able to have a conversation without it escalating. A child whose anxiety is affecting the whole household. A bereavement, a divorce, a major move, or a family member’s illness that nobody quite knows how to navigate together.

In these moments, family therapy can be one of the most powerful forms of support available. Not because families that seek it are somehow broken or failing — but because some problems genuinely belong to the system, and the system needs to be part of the solution.

This post is a comprehensive guide to family therapy: what it is, when it helps, what it involves, what to look for in a family therapist, and how to know when it’s the right time to reach out.

What Is Family Therapy?

Family therapy (sometimes called family counseling or systemic therapy) is a form of psychological treatment that involves working with multiple family members together, with a trained therapist who understands how families function as systems.

The foundational idea of family therapy is that many individual struggles are shaped by — and in turn shape — the patterns of relationship within the family. A child’s anxiety, for example, doesn’t exist in isolation: it develops within a particular family context, and it affects every member of that family. Similarly, conflict between parents ripples outward to children, even when parents believe they are shielding them from it. The family is a system, and what affects one part of the system affects all of it.

Family therapy takes this systemic perspective seriously. Rather than identifying one person as ‘the problem’ and treating them in isolation, it works with the whole family to understand the patterns that have developed and to create the conditions for change.

When Does Family Therapy Help? Common Situations

Family therapy is appropriate for a wide range of situations. The following are some of the most common contexts in which families seek this kind of support.

Adolescent and teenage struggles

The teenage years are a period of significant developmental change — in the adolescent’s brain, sense of identity, social world, and relationship to the family. For many families, this period involves some degree of friction as teenagers seek greater independence and parents struggle to adjust their role accordingly.

But for some families, the transition becomes significantly more difficult. A teenager who has become withdrawn, angry, or emotionally volatile. A young person who is struggling with anxiety, depression, eating difficulties, or self-harm. A teenager who seems to have completely shut down communication with their parents. These situations call for professional support that takes both the teenager’s experience and the family system seriously.

Family therapy in these situations typically helps parents understand what their teenager is experiencing (and what they may be misreading), improves communication in ways that the teenager can actually receive, and supports the whole family in navigating the transition rather than fighting against it.

Divorce, separation, and blended families

Divorce and separation are among the most significant stressors a family can experience — and their impact on children is profoundly shaped by how the adults manage the transition. Family therapy can help parents develop a co-parenting relationship that genuinely prioritises the children’s wellbeing, even amid their own grief and anger. It can also help children at different developmental stages make sense of what is happening, maintain their relationship with both parents, and process their own feelings about the changes.

Blending two families together brings its own complex dynamics: step-siblings who may not want to live together, step-parents negotiating their role with children who already have two parents, loyalty conflicts, and the challenge of building new family rituals and norms when everyone is starting from different places. Family therapy can provide a structured space to work through these challenges before they solidify into patterns that are harder to shift.

Grief and loss

The death of a family member — whether expected or sudden — affects each person in the family differently, and can create unexpected difficulties in the family system. One person’s way of grieving may feel incomprehensible or even offensive to another’s. Children’s grief often looks different from adults’, and parents who are themselves devastated may struggle to provide the support their children need.

Family therapy following bereavement creates a space where every member’s grief can be acknowledged and respected, where the family can develop a shared way of honouring the person they have lost, and where the adjustments required by the loss can be navigated together rather than in painful isolation.

A family member’s mental health or illness

When one family member is dealing with a significant mental health condition — a parent’s depression, a child’s anxiety disorder, a teenager’s eating disorder, a grandparent’s dementia — the impact on the whole family can be profound. Other family members may feel helpless, frightened, resentful, or guilty. They may inadvertently behave in ways that make the situation worse, not because they don’t care but because they don’t know what would actually help.

Family therapy in these situations educates the family about the condition, helps them understand what the struggling member is experiencing, supports them in developing helpful responses (and unlearning unhelpful ones), and provides a space for everyone’s experience to be acknowledged — not just the person who is most visibly struggling.

Communication breakdown and chronic conflict

Some families develop entrenched patterns of communication that have become deeply unproductive — patterns of criticism, contempt, stonewalling, or defensiveness that have calcified over years. Individual members may genuinely want things to be different but feel powerless to change the pattern on their own, because the pattern is bigger than any individual’s behaviour.

Family therapy can interrupt these cycles by helping family members understand how the pattern works — who does what, in response to what, creating what response in return — and by developing the communication skills and relational practices that allow the pattern to change.

What Family Therapy Actually Involves

Many people have a vague sense of what family therapy involves but aren’t sure what to expect in practice. Here is an honest picture of what the process typically looks like.

The initial sessions: Getting to know the family

The early sessions are primarily about the therapist getting to understand the family: its history, its structure, its patterns, the different perspectives of its members, and what has brought them in. A good family therapist will be genuinely curious about each member’s experience — including the children, who are often asked directly (in age-appropriate ways) how they see the situation.

The therapist is also observing the family during these early sessions — not in a clinical, distancing way, but in the sense of paying attention to the patterns that emerge. How does the family manage disagreement in the room? Who speaks first? Who goes quiet? Who looks to whom when things become tense?

Building safety and trust

For family therapy to work, every member of the family needs to feel safe enough to be honest. This is particularly important for children and teenagers, who may worry that what they say will be reported back to their parents or used against them. A skilled family therapist works hard to create an environment where every voice matters and where no one is made to feel like the problem.

Sometimes this involves seeing different members of the family separately before bringing them together, to ensure that everyone has had a chance to speak candidly and to help the therapist understand different perspectives more fully.

The work itself

Family therapy sessions typically run for 50 minutes to an hour. The content of sessions varies depending on what the family is working on — sometimes it involves structured exercises or activities (particularly with younger children), sometimes it is more conversational, sometimes the therapist works explicitly with the patterns that emerge in the room.

The work is collaborative — the therapist is not there to tell the family what to do, but to help them understand themselves and each other more clearly, and to support them in developing new ways of relating. This means the sessions can sometimes feel uncomfortable, particularly when difficult truths are being named — but a skilled therapist manages the pace carefully and ensures that the family never moves faster than it can sustain.

Between sessions

Family therapy is not only what happens in the room. The therapist may suggest things to try between sessions — specific conversations to have, activities to do together, or new responses to practise when familiar triggers arise. These between-session practices are an important part of how change is consolidated.

Who Attends? Navigating the Practicalities

One of the practical questions families often have about family therapy is who needs to attend. The answer varies depending on the situation and what the family is working on.

In some cases, all members of the household attend every session. In others, the work begins with the parents (or the adults) and brings in children or teenagers once a foundation has been established. Sometimes individual sessions for a specific family member run alongside family sessions. And sometimes the most helpful approach is to work primarily with the parents, supporting them in changing the patterns that are affecting the children.

If a child or teenager is resistant to attending, this is worth discussing with the therapist rather than forcing the issue. A good therapist can often suggest approaches for engaging a reluctant family member, and can also work usefully with the family even in that member’s absence — because changes in the system affect everyone in it, even those who aren’t in the room.

How to Choose a Family Therapist

A few things worth bearing in mind:

• Look for a therapist with specific training and experience in family or systemic therapy. This is a specialised area and not all therapists are equally equipped to manage the complexity of working with multiple people simultaneously.
• Consider whether the therapist has experience with the specific situation you’re navigating — adolescent work, divorce, bereavement, or whatever is most central to your family’s situation.
• Take the first session seriously as an assessment of fit. Does every family member feel that the therapist is genuinely interested in their experience? Does the therapist seem able to hold the complexity without siding with any one person?
• Be honest about practical constraints. Family therapy requires scheduling that works for multiple people with different commitments — the right therapist will take this seriously rather than being rigid about when sessions can happen.

A Note About What Family Therapy Is Not

Family therapy is not about identifying a scapegoat, or finding someone to blame. It is not about convincing one family member that they are the problem. It is not about forcing people to talk before they are ready, or dragging things into the open that everyone would rather leave buried.

At its best, family therapy is about creating the conditions under which each member of the family can be genuinely seen and heard — and in which the family as a whole can move toward something healthier and more sustaining for everyone.

You don’t have to wait until the family is in crisis to seek support. Many of the families who benefit most from family therapy come in at a point where things are difficult but not yet broken — and leave with tools and understanding that serve them for years.

At The Counseling Place, we offer family therapy for families of all shapes and sizes — biological families, blended families, single-parent families, and multi-generational families. Our therapists have experience working with children as young as 3, teenagers, adults, and every combination in between. We offer in-person sessions in Lone Tree and Greenwood Village, Colorado, and telehealth for families across Colorado.

Frequently Asked Questions

Does everyone in the family have to want to come to therapy?

Not necessarily. While willing participation from all members is ideal, family therapy can still be beneficial even when some members are reluctant. A skilled therapist can often engage resistant family members over time, and changes in how other family members behave can create shifts in the system even for those who are not fully engaged. If a key family member refuses to attend at all, it is still worth discussing with a therapist what options exist.

Will the therapist take sides?

A skilled family therapist works hard to remain genuinely impartial — not in the sense of never challenging anyone, but in the sense that every member’s experience is held with equal respect. This is a core skill in family therapy and one of the most important things to assess in a first session. If any member consistently feels sided against, it is worth raising this directly with the therapist.

How is family therapy different from having my child see an individual therapist?

Individual therapy for a child or teenager focuses primarily on that person’s internal experience and development. Family therapy focuses on the patterns of relationship within the family system. Often the two approaches are complementary: a child may benefit from individual therapy to process their own experience, while the family benefits from family therapy to shift the dynamics that are affecting everyone. Your therapist can help you think through which combination is right for your situation.

What age do children need to be to participate in family therapy?

There is no strict minimum age. At The Counseling Place, we work with children as young as 3. Very young children participate in age-appropriate ways — through play, drawing, or simply being present — and a skilled family therapist knows how to engage them meaningfully. The way children are included will be adapted to their developmental stage.

How long does family therapy usually take?

This depends on what the family is working on. Some families find that 8–12 sessions addressing a specific issue gives them what they need. Others dealing with more complex or long-standing dynamics benefit from longer-term work. Many families also find it helpful to return to therapy at different points — for example, when children reach a new developmental stage, or when the family faces a new challenge. Your therapist will discuss realistic expectations with you after the first few sessions.